一位上消化道腐蝕性潰瘍病患之護理經驗

The Nursing Experience of Caring for a Patient with Upper Gastrointestinal Tract Corrosive Injury

本文探討一位無法因應生活狀況改變而喝水管疏通劑自我傷害之患者的護理經驗，護理期間運用Gorden十一項健康功能評估，確立個案的護理問題有：急性疼痛、營養不良-少於身體需要及無效性因應能力等問題，筆者藉由主動關懷，並與個案建立信任的護病關係，協助建立支持系統，提供適當的護理措施，減輕個案口咽疼痛和吞嚥困難的情形，藉由完整的支持系統鼓勵並引導其抒發負面情緒，協助個案正視自我傷害的導因，可以正向的認知及態度面對，尋求可運用之社會支援，而在情緒低落時，可利用適當方法抒解情緒壓力。此外，對於自我傷害患者臨床護理不僅於提供生理照護需求，更應重視疾病以外心理層面諸多問題，使達完整的照護品質。並期望藉此護理經驗之分享，能提供護理人員臨床照護之參考。

This article describes the nursing experience of a patient with upper gastrointestinal tract corrosive injury who swallowed household cleaning products. Based on parameters provided by Gordon 11-item functional health pattern assessment guide, the patient was identified as suffering from the acute pain, nutrition less than body requirements, and ineffective coping skills. Data were collected through interviews, observation, and physical assessments. During the course of providing nursing care, the author established a good relationship with the patient through devoted attention to the patient's needs and by actively caring, listening, accompanying and complete support system. The author offered the appropriate nursing interventions to reduce oropharyngeal pain as well as difficulty in swallowing. The patient was guided to express negative emotions and encouraged to face life with a more positive attitude and express the reason leading to suicide. When confronted with problems, the patient could therefore take on a positive cognition and attitude and seek social support. Nurses are encouraged attend to paitent’s physical care needs as well as mental wellness to achieve a comprehensive quality of nursing care. It is hoped that the report can provide nursing staff with a reference for caring patients with similar problems.